Previously known management of diseases, such as chronic diseases, has various drawbacks. In traditional clinical surveillance of a patient who is suffering from a disease, such as chronic disease, and who spends most time as an outpatient, e.g. at home, the patient has a restricted number of meetings annually with a physician. These meetings usually take place in the clinic where the physician is based. During the meeting the development of the disease since the previous meeting is discussed between the patient and the physician for planning of continued therapy. At the best, the patient has made handwritten notes before the meeting at a regular or irregular basis. However, the notes are most often not read by the physician due of a lack of time needed to analyze the notes. Hence, while the physician often only is informed of the latest occurrences by the patient during the elapsed period, due to insufficient memory of the patient, many previous events are missed out and not considered by the physician. The patient has for instance simply forgotten these events, or forgotten to annotate the events, or wrongly annotated some events, or even annotated incorrect information related to such events. A common behavior is that patients do not want to trouble the doctor, and therefore withhold information from the doctor. Many patients do also not want to be sick, which has an influence on the disease related information given to the doctor.
Furthermore, while a patient gets prepared to meet a physician for such an appointment, the patient adopts intentionally or non-intentionally a recovered façade. By keeping up appearances, the patient shows a more healthy appearance towards the physician than the actual health condition actually is. Thus, the physician gets an inadequate physical and mental impression of the patient.
A consequence of the missed out information, following the physician's interpretation based on the visual impression of the patient status may be that substantial information that could affect the physician's judgment of the patient status is eluded. Thus, the subsequent advice and potential ordinations and amendments of prescriptions made by the physician may be substantially different from objective prescriptions. The patient may be advised to take a less effective dose, or a less effective type of medication, compared to when correct information was provided during the meeting between the patient and the physician.
For chronic patients, e.g. suffering from Parkinson's disease (PD), the above scenario is not uncommon and is an obstacle to overcome for the health providers, e.g. physicians responsible for correct treatment of the patient.
Electronic note keeping systems for collecting information such as above are an alternative. Known devices available on the market include handheld devices that may be used for storing information, including pocket pc's, mobile telephones, etc. However, these devices are difficult to handle for certain patients, in particular some elderly persons. In addition, due to extremely short life cycles before new models emerge, such devices are not suitable for long-term surveillance of a patient. For instance, costly adaptations of software or hardware have to be made in close intervals. Also, reliability of such devices is an issue, as frequent software updates and changes of hardware platform are not always a benefit for neither the patient nor the physician. Sequentially, as new hardware and new implementations are introduced, additional training is needed for personnel responsible at the health provider to secure adequate outcome of the monitoring and diagnosis.
In addition, commonly more obvious is the appearance especially concerning PD patients the presence of undesired motoric movement of some part of the body, e.g. a tremor of a limb such as an arm or a leg. These tremors occur because of an inadequate level of non-dopamine in the brain of the patient. However, only about 68% of the diagnosed PD patients suffer from such tremors and about half of these patients categorize these undesired movements as troublesome and/or embarrassing.
Systems to monitor and measure these tremors have been disclosed in e.g. EP0535508, or WO2008037260. These systems monitor and categorize the seriousness of the tremors in terms of momentarily measurements of motoric movements of a patient limb. However, the measurement outcome reflects the patient status at the specific time of measurement. More specifically, if anti-tremor medication prescribed by a physician, based on such measurements, the tremors are suppressed. The medication has to be taken in a certain dosage and in certain time intervals. However, when tremors are inhibited, the systems of e.g. EP0535508, or WO2008037260 provide no useful measurement values for a follow-up of the treatment. Hence, these systems are only beneficial tools for the physician and the patient suffering from undesired movements on a short term perspective. However, any approach to conjointly reduce or eliminate long term trends in the progression of the disease or treatment thereof is absent.
Hence, an improved patient friendly medical device and/or method, at least suitable for long-term monitoring, would be advantageous and in particular a portable apparatus allowing for increased flexibility, cost-effectiveness, easy handling in particular by a elderly patient population and/or user friendliness would be advantageous. There is a desire to provide such a device and/or method having high acceptance thanks to a low technical barrier experienced by the users when monitoring such patient population.